Schizophrenia Booklet 6: Psychological therapies

Question 1

What are the three types of psychological treatments on the spec?

Answer 1

-CBT
-Family Therapy
-Token Economies

Question 2

What is CBT?

Answer 2

-Main psychological treatment for people with sz
-Can be completed on an individual basis or in a group
-Ranges from 5 session to 20

Question 3

What is CBT based on?

Answer 3

The idea that the development of SZ is linked to dysfunctional thoughts, so CBT works by identifying and changing maladaptive and irrational thoughts in people

Question 4

What symptoms does cbt target

Answer 4

Positive symptoms

Question 5

What is one form of CBT for SZ?

Answer 5

Personal Therapy

Question 6

What is Personal Therapy?

Answer 6

A detailed evaluation of the problems and triggers of irrational thoughts, it involves the therapist and client working together to create coping techniques

Question 7

What are some examples of coping techniques in Personal Therapy?

Answer 7

-Distractions from intrusive thoughts
-Challenging the meaning of intrusive thoughts
-Increasing/decreasing social activity to distract from low moods

Question 8

What are the evaluations of CBT?

Answer 8

😀Effective (Tarrier)
😀More appropriate than drug therapy (side effects)
😥Less appropriate (more expensive)
😥Less appropriate (severe sz symptoms)

Question 9

What did Tarrier find about CBT?

Answer 9

Reviewed 20 controlled trials of CBT using 739 patients, found persistent evidence of reduced symptoms, especially positive symptoms, lower relapse rates and speedier recovery time in the short-term

Question 10

What is family therapy?

Answer 10

-A form of psychotherapy based on the idea that family dysfunction causes sz
-So altering relationship and communication patterns in families help sz patients recover
-In particular, lowering expressed emotion

Question 11

What makes family therapy different to other therapies?

Answer 11

Involves the whole family instead of just the individual

Question 12

What are some examples of what family therapy would do?

Answer 12

-Improve positive and decrease negative communication
-Increase tolerance and decrease criticism levels between family
-Decrease guilt and responsibility for causing illness among family
-Form therapeutic alliance with all family members

Question 13

How long does family therapy happen for?

Answer 13

Around 9-12 months

Question 14

What are the evaluations of family therapy?

Answer 14

😀/😥Effective (Leff)
😀Appropriate (severe symptoms)
😀Appropriate (cheaper, Schizophrenia Commission)
😥Not appropriate all families

Question 15

What did Leff find to support and contradict the effectiveness of family therapy

Answer 15

-Compared family therapy with routine outpatient care for schizophrenics with families with high EE. Found within the first 9 months of treatment 50% of those who experienced routine care relapsed, compared with only 8% receiving family therapy
-However after 2 years of treatment 75% of patients had relapsed and 50% who experienced family therapy

Question 16

What did the Schizophrenia Commission say about the costs?

Answer 16

Estimated that family therapy is cheaper than standard care by about £1000 a patient over three years

Question 17

What are token economies?

Answer 17

A behaviourist therapeutic approach to the management of schizophrenia, where tokens are awarded when patients show a desired behaviour

Question 18

Which symptoms do token economies particularly target?

Answer 18

Negative symptoms such as avolition and lack of motivation

Question 19

Where are token economies mainly used?

Answer 19

Long term hospitalised patients

Question 20

What do the tokens do?

Answer 20

They can be exchanged for goods and privileges which give direct pleasure

Question 21

What are the evaluations of token economies?

Answer 21

😀Evidence of effectiveness (Ayllon and Azrin)
😥Only work in institutions
😀Can be personalised
😥More effective for those with mild symptoms, than severe

Question 22

What was found in Ayllon and Azrin?

Answer 22

Found token economies were successful through rewarding female schizophrenic patients that were hospitalised, they were rewarded for behaviours like making a bed and brushing hair. They found that average number of chores completed rose from 5 to 42

Question 23

What comparison points can be considered between treatments?

Answer 23

-Which approach is it?
-Are they appropriate for severe sz?
-Positive and/or negative symptoms
-How effective long/short term?
-Side effects?
-Do they require a therapist?
-Ethical?
-Work for all patients?